The promise and potential of diabetes reversal

TELUS Health Annual Conference 2020

“Type 2 diabetes can be reversed.”

Just a few years ago such a statement would have been frowned upon if not censored in medical practice, said Dr. Brendan Byrne, Medical Director and co-founder of Wellness Garage in White Rock, B.C., during his live webinar on June 2, presented by TELUS Health. A full recording of the webinar is available below.

Fast forward to today and the growing clinical evidence—as well as living proof in his own medical practice—has led Bryne to say these words again and again to patients, colleagues and everyone else who stands to benefit, including plan sponsors of private group insurance benefit plans.

“We have to think differently and move away from the dominant paradigm that diabetes is about glycemic control,” said Byrne. “Just because there is a diagnosis does not mean it cannot be reversed.”

Carefully controlled weight loss is the key. Byrne presented results from the DiRECT clinical trial in the U.K., which found that after one year almost half of participants who had lost weight were in remission from type 2 diabetes. The remission rate increased to 73% when the weight loss was greater than 10 kg, and 86% when it was more than 15 kg.

Weight loss is one of a number of lifestyle changes, such as exercise and smoking cessation, that have long been recommended in order to slow the progression of diabetes. However, historically many patients find lifestyle changes too difficult to maintain and come to rely more on medications to manage their disease.

The promise of remission can be a powerful motivator, stressed Byrne. His educational program on diabetes reversal is seeing “phenomenal uptake. Very few people with type 2 diabetes don’t want to reverse it. Most just don’t know that it’s possible.”

Role of employers

Employers can help create awareness; however, before doing so a proper program, built upon medical evidence, needs to be in place. He challenged plan sponsors and insurance carriers to begin with pilot programs in order to develop the proof of concept necessary to roll this out as a standard benefit offering. “This is something we need to work at systematically.”

Byrne also considered the return on investment for employers. Currently, based on the average age of diagnosis at 45 years, total medication costs for an employee with type 2 diabetes could be more than $50,000 by the age of retirement. Factoring in reduced productivity and missed work, the cost to the employer could be more than $80,000—and that does not take into account disability leaves or costs due to comorbidities such as hypertension and depression (click here for more information on the total cost impact of plan members with diabetes).

A type 2 diabetes reversal program, on the other hand, would cost between $2,000 and $4,000 over the course of the first year (based on the program in his practice), with low or no maintenance costs after that (depending on the needs of the patient). “You start to see there is going to be a significant return,” said Byrne.

During his webinar, Byrne discussed possible scenarios that could trigger the offering of a reversal program type 2 diabetes. He also gave a simple explanation of the “four plus two” components of his program: whole foods, increased activity, liver protection and intermittent fasting. Stress management and improved sleep are also important factors.

See below for the complete recording of the webinar and to download the presentation.